Treatment/procedure for nasal flair when smiling - Can Botox be used for this?

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin - Winnetka & Chicago. This is a great question. You're right to notice that Botox for nasal flare—particularly dynamic nostril widening when smiling—is not commonly showcased or widely advertised, and there’s a good reason for that. While Botox can be used to reduce nasal flare, it’s an off-label, highly specialized application that few injectors perform regularly. The technique involves injecting very small amounts of botulinum toxin into the nasalis muscle or levator labii alaeque nasi, which are responsible for nostril dilation and upper lip elevation during expressive movement. The reason you haven’t seen many before-and-after photos is because results are typically subtle, the treatment is not commonly requested, and most patients seek more noticeable rejuvenation procedures rather than this very targeted correction. If nasal flare is your only concern and you’re looking for a quick recovery option, Botox could be a viable, low-risk trial, especially since it wears off within 3–4 months. I hope this helps and best of luck!

The short answer is that a microdroplet or two of Botox into the "wings" at the base of the wings of the nose has been used for many years to treat smile-related nasal flaring. The reason that you likely have not seen much about this is because the problem is not that common and so the demand for this particular treatment approach is very uncommon and overshadowed by the more common treatment sites like the glabellar frown lines, crow's feet lines around the eyes, and the forehead worry lines. You would be wise to seek treatment by experienced, board certified cosmetic dermatologist injection expert.

Thank you for your thoughtful question. Nasal flaring that occurs when smiling is often due to overactivity of the dilator naris muscles, which can pull the nostrils outward or upward. While this can be a normal part of facial animation, it can become a cosmetic concern for some individuals.

Can Botox Be Used for Nasal Flaring?
Yes — Botox can be used to address nasal flaring in some cases, though it's a less common application and should be performed by someone experienced in advanced facial anatomy.

A very small dose (1–2 units per side) can be injected into the dilator naris muscle.

This weakens the muscle's contraction and reduces nostril flaring, especially when smiling or expressing.

The result is subtle but effective in properly selected candidates.

Why Is It Not Widely Seen or Documented?
It's a specialized injection technique, not routinely offered by all injectors.

Results are typically subtle and not as dramatic as other Botox applications, which is why before-and-after photos are rare.

Variability in anatomy and expression patterns also means that patient selection is key.

Alternative Options
If Botox is not sufficient or appropriate, other interventions include:

Surgical alar base modification (alar reduction):
A minor surgical procedure to permanently reduce nostril width or flare. This does involve downtime and may leave small scars.

Thread lifting (for dynamic nostril movement):
In select cases, lifting threads can help stabilize nostril movement but are less common and not always reliable for this issue.

Summary
Botox can be a valid option for treating nasal flaring when smiling, particularly if the cause is muscle overactivity. Though not widely publicized, it is used in advanced aesthetic practices and can offer a minimally invasive, low-downtime solution.